Case Study

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Case StudySeanBy Ailsa Walker (student PT) 2013GoalMums goals for the term were as follows:increase Gross Motor development (standing and walking).acquire new cut-out table and new AFOs.to have more ideas for fine motor skillsCommunication development.Activities included:sit-to-stand practicecrawlingreaching and rotation in standingweight shift from one foot to the otherlong sittingresisted walkingindependent standingSession OutcomesGas goal will be assessed this week.CPL will continue with ongoing assessment and therapy to increase Sean's independence with his mobility, to improve his participation in home and school activities and to increase his confidence (for further information see the FSP.)Activities and exercises that Sean can do at home to help his development were discussed with mum and demonstrated during therapy.A report could be made to provide the family with solid information for their own reference in the home.BackgroundBirth History:Born 32weeks, ventilated for 4hrs.PMHx: Encephally found on MRI at 6mnths, Squint operation to correct vision.Diagnosed with CP at 13months old.Irritable hip syndrome diagnosed at last hip x-ray.ActivityLimitation with transitions and needs supportdecreased swing phase in gaitcan mobilise with walker on flat even surfacecan perform ball rolling with support for regaining balancecan reach outside base of support in sitting and standing requiring minimal assistance to regain balance.displays poor weight bearing when using walker.can walk independently using walkercan sit independentlylimited participation in weight bearing activities as he requires to hold on to something for balance.able to use UL's in 'W' sitting for bi-manual play.unable to use UL's for bi-manual tasks in standing/ walking.unable to keep up with peers and socialise appropriately due to mobility restriction.able to perform meaningful play in sitting and when supported in standing.dependent for ADLs such as hygiene, toileting, dressing, eating and drinking.Participation Assessment findingsMAS Grade 2Spasticity and increased tone in hamstrings, abductor and calves.Decreased hip abduction ROM.Decreased pelvic and trunk control.Decreased awareness of body in space.It was reported that he handles all consistencies of food well, only very ocaasionally coughing.Body Structure and Function3 yr old boyCerebral Palsy, Spastic Di-plegia.Peri-ventricular leuko malaciaGMFCS: IIIMACS: IVIrritable hip syndrome.Botox for adductors March 2014Week 2Week 4Week 3Week 5Session Plans & RationaleIncluded activities that allowed:stretchingstanding and reaching, trunk rotation, sit to stand practice,walking against resistance,long sitting,obstacle avoidance.These activities were selected to target;increasing swing phase in gait,increase independent standing time,decrease trunk sway when walking,increase control of gross motor movements,improve standing balance following internal pertebationimprove weight transfer from one leg to the other in standing,practice lower limb dissociation and half halg kneelinglower limb strengthPersonal Factorscommunication: bi-lingual English and French, uses sentence formationcognition: appears good.very cooperative & sociableenjoys cars, building games and task orientated activitiesSupportive family: Mo Virginie, Fa William, 2x older sisters.Equipment:Kaye Walker, articulated AFOs.Schooling:conductive education weeklyOther professional support and services:Allied Health team at CPLMater Health ServiceGP: Dr JosephOrthopaedic Sx: Dr WalshNeurologist: Dr WallaceOpthamologist: Dr YuenPrivate Speech Pathologist.Environmental Factors